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In Node-Negative Breast Cancer, Micromets Not Necessarily Worthy of Heavy Pursuit

Posted Date: January 21, 2011

National Surgical Adjuvant Breast and Bowel Project (NSABP) trial B-32 trial investigators have examined the impact of micrometastases and isolated tumor cells on the survival of women with breast cancer who initially have clinically negative axillary lymph nodes.

National Surgical Adjuvant Breast and Bowel Project (NSABP) trial B-32 trial investigators have examined the impact of micrometastases and isolated tumor cells on the survival of women with breast cancer who initially have clinically negative axillary lymph nodes. The results of the National Surgical Adjuvant Breast and Bowel Project (NSABP) trial B-32 were published on January 19th, 2011 in the New England Journal of Medicine.

The study found that “occult” metastases are an independent prognostic variable. Women who had the micromets—the term for the combination of micrometastases and isolated tumor cells—had statistically significantly worse overall and disease-free survival. The difference in overall survival at 5 years was “small” (1.2%) between the women with and without these occult micromets. The authors suggest that the extensive pursuit of tiny pieces of cancer in such patients may not be worth the effort. In practice, women and their breast surgeons will have to decide on an individual basis what approach makes the most sense, balancing this new information against the risks and benefits of more aggressive surgery.

Read the full study in the New England Journal of Medicine